Abstract
Obsessive–compulsive disorder (OCD) is characterized by the presence of distressing, recurrent and intrusive thoughts, impulses, or doubts as well as behavioral or mental rituals. OCD has various subtypes, including the fear of contamination in which individuals fear bacteria, germs, disease, or bodily secretions, and engage in clinically significant cleaning and avoidance rituals. Cognitive–behavioral therapy (CBT) is an effective treatment for OCD and involves, among other therapeutic strategies, exposing patients to feared stimuli while preventing them to engage in compulsive behaviors. In recent years, virtual reality (VR) has shown the potential of in virtuo exposure with people suffering from anxiety disorders and OCD. The objective of this pilot study is to examine the effectiveness of a CBT program where exposure in conducted in virtuo. Three adults suffering from OCD with a dominant subtype of contamination were enrolled in a single-case design with multiple baselines across participants. The presence and intensity of obsessions and compulsions were assessed daily during baselines of 3-, 4-, or 5-week, and a 12-session treatment. Follow-up information was gathered after 4 and 8 months. Treatment outcome is assessed with visual inspection of the graphs and ARMA time-series analyses. Clinical information, self-reports, and details of the treatment are provided for each patient. Statistical analyses for the time-series data revealed a statistically significant improvement in all three participants, but global improvement is considered positive for only two. This study innovates in proving preliminary support for the usefulness of VR in the CBT of OCD with contamination features.
Highlights
Obsessive–compulsive disorder (OCD) is a severe and debilitating mental disorder characterized by recurrent and intrusive thoughts, impulses, or doubts that cause marked anxiety in individual, as well as behavioral or mental rituals that are performed in order to reduce distress caused by the obsessions
The difference between the two populations is the importance given to the presence of thoughts; people with OCD attribute much more importance to their thoughts and their ability to control them than the general population
Subtyping OCD symptoms does not necessarily imply the need to develop different theoretical models and treatments for each subtype [2, 3], but is very important in terms of clarifying the stimuli that will be targeted in psychotherapy
Summary
Obsessive–compulsive disorder (OCD) is a severe and debilitating mental disorder characterized by recurrent and intrusive thoughts, impulses, or doubts that cause marked anxiety in individual, as well as behavioral or mental rituals that are performed in order to reduce distress caused by the obsessions. Fears may be related to contamination, doubts, orderliness, religion, morality, aggression, or sexuality. When it comes to compulsions, the most common are cleaning/ washing, checking, ordering/symmetry, and accumulating. People with a fear of contamination are absorbed by worries such as fear of microbes, bacteria, diseases, bodily fluids, and chemicals. To ease their fears, they feel the urge to wash excessively (hands, body, teeth, clothes), clean household items or personal property, and avoid situations in which there are risks of contamination. Subtyping OCD symptoms does not necessarily imply the need to develop different theoretical models and treatments for each subtype [2, 3], but is very important in terms of clarifying the stimuli that will be targeted in psychotherapy
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